Crystal's MCW Coder HubDEFINITION of embolism
An embolism occurs when an embolus — a solid, liquid, or gaseous mass — travels through the circulatory system and lodges in a vessel too narrow to allow its passage, obstructing blood flow. The embolus can originate from a thrombus (blood clot), fat (from long bone fractures or liposuction), air/gas (from IV lines, surgery, or barotrauma), amniotic fluid (obstetric complication), septic material (infected vegetation from endocarditis), tumor fragments, cholesterol crystals, or orthopedic bone cement. The clinical consequences depend on where the embolus lodges: the pulmonary circulation (pulmonary embolism/PE) causes hypoxia and right heart strain; the systemic arteries (arterial embolism) causes acute ischemia to organs or extremities; the cerebral circulation causes stroke or TIA; the venous system (deep vein thrombosis/DVT) represents the thrombus source most commonly leading to PE. Embolism is distinct from thrombosis (in-situ clot formation), though both may coexist and ICD-10 often codes them together.
ETYMOLOGY of embolism
Component Origin Meaning embol- Greek embolos (ἔμβολος), from emballein A plug, wedge, or stopper; “to throw in” or “to insert” -ism Greek -ismos A condition, process, or pathological state Literally: “a condition of plugging” — from the image of a wedge or stopper being thrown into a vessel and blocking it. The term was coined by Rudolf Virchow in the 1840s, the same pathologist who described Virchow’s Triad (the three factors predisposing to thromboembolism).
By Type of Embolus:
- Thromboembolism — embolus arising from a blood clot (most common type)
- Pulmonary embolism (PE) — thrombus lodged in pulmonary artery
- Deep vein thrombosis (DVT) — the most common source of PE
- Arterial embolism — embolus in a systemic artery
- Fat embolism / Fat embolism syndrome (FES) — fat globules, often post-fracture
- Air embolism / Gas embolism — air in venous or arterial system
- Septic embolism — infected thrombus, often from endocarditis
- Cholesterol embolism / Atheroembolism — cholesterol crystals from plaque rupture
- Tumor embolism — malignant cells in circulation
- Amniotic fluid embolism (AFE) — obstetric emergency
- Cement embolism — acrylic bone cement (orthopedic procedures)
- Paradoxical embolism — venous embolus crossing to arterial circulation via PFO/ASD
By Location:
- Saddle embolus — large embolus straddling a bifurcation (e.g., pulmonary artery bifurcation or aortic bifurcation)
- Massive PE — causing hemodynamic instability/shock
- Submassive PE — with right heart strain but without shock
- Subsegmental PE — in the smallest pulmonary arterial branches
- Chronic thromboembolic pulmonary hypertension (CTEPH) — long-term PE complication
- Thrombus — the in-situ clot that becomes an embolus when it breaks off
- Virchow’s Triad — hypercoagulability, venous stasis, endothelial injury (risk factors for thromboembolism)
- DVT (Deep Vein Thrombosis) — most common PE source; category I82
- Cor pulmonale — right heart failure from pulmonary hypertension due to PE
- Infarction — tissue death from embolic arterial occlusion
- Anticoagulation — primary treatment (heparin, warfarin, DOACs)
- Thrombolysis (tPA) — for massive/life-threatening PE
- Thrombectomy / Embolectomy — surgical or catheter-based removal
- IVC filter — inferior vena cava filter to catch emboli
- V/Q scan — ventilation-perfusion scan for PE diagnosis
- CT Pulmonary Angiography (CTPA) — gold standard PE imaging
- D-dimer — screening lab for thromboembolism
- Wells score / PERC rule — clinical prediction rules for PE probability
### 🏥 ICD-10-CM CODESPulmonary Embolism (Category I26)
Code Description I26.01 Septic pulmonary embolism with acute cor pulmonale I26.02 Saddle embolus of pulmonary artery with acute cor pulmonale I26.03 Cement embolism of pulmonary artery with acute cor pulmonale I26.04 Fat embolism of pulmonary artery with acute cor pulmonale I26.09 Other pulmonary embolism with acute cor pulmonale I26.90 Septic pulmonary embolism without acute cor pulmonale I26.92 Saddle embolus of pulmonary artery without acute cor pulmonale I26.93 Single subsegmental thrombotic pulmonary embolism without acute cor pulmonale I26.94 Multiple subsegmental thrombotic pulmonary emboli without acute cor pulmonale I26.95 Cement embolism of pulmonary artery without acute cor pulmonale I26.96 Fat embolism of pulmonary artery without acute cor pulmonale I26.99 Other pulmonary embolism without acute cor pulmonale I27.82 Chronic pulmonary embolism Arterial Embolism & Thrombosis (Category I74)
Code Description I74.01 Saddle embolus of abdominal aorta I74.09 Other embolism and thrombosis of abdominal aorta I74.10 Embolism and thrombosis of unspecified parts of aorta I74.11 Embolism and thrombosis of thoracic aorta I74.19 Embolism and thrombosis of other parts of aorta I74.2 Embolism and thrombosis of arteries of the upper extremities I74.3 Embolism and thrombosis of arteries of the lower extremities I74.4 Embolism and thrombosis of arteries of extremities, unspecified I74.5 Embolism and thrombosis of iliac artery I74.8 Embolism and thrombosis of other arteries I74.9 Embolism and thrombosis of unspecified artery I76 Septic arterial embolism Venous Embolism & Thrombosis — DVT (Category I82, selected)
Code Description I82.411 Acute embolism and thrombosis of right femoral vein I82.412 Acute embolism and thrombosis of left femoral vein I82.421 Acute embolism and thrombosis of right iliac vein I82.422 Acute embolism and thrombosis of left iliac vein I82.431 Acute embolism and thrombosis of right popliteal vein I82.432 Acute embolism and thrombosis of left popliteal vein I82.441 Acute embolism and thrombosis of right tibial vein I82.442 Acute embolism and thrombosis of left tibial vein I82.451 Acute embolism and thrombosis of right peroneal vein I82.452 Acute embolism and thrombosis of left peroneal vein I82.3 Embolism and thrombosis of renal vein I82.B11 Acute embolism and thrombosis of right subclavian vein I82.B12 Acute embolism and thrombosis of left subclavian vein I82.A11 Acute embolism and thrombosis of right axillary vein I82.A12 Acute embolism and thrombosis of left axillary vein I82.90 Acute embolism and thrombosis of unspecified vein I82.91 Chronic embolism and thrombosis of unspecified vein Cerebral Embolism (causing infarction)
Code Description I63.131 Cerebral infarction due to embolism of right carotid artery I63.132 Cerebral infarction due to embolism of left carotid artery I63.111 Cerebral infarction due to embolism of right vertebral artery I63.112 Cerebral infarction due to embolism of left vertebral artery I63.19 Cerebral infarction due to embolism of other precerebral artery Traumatic & Special Types (Category T79)
Code Description T79.0XXA Air embolism (traumatic), initial encounter T79.0XXD Air embolism (traumatic), subsequent encounter T79.0XXS Air embolism (traumatic), sequela T79.1XXA Fat embolism (traumatic), initial encounter T79.1XXD Fat embolism (traumatic), subsequent encounter T79.1XXS Fat embolism (traumatic), sequela History / Status
Code Description Z86.711 Personal history of pulmonary embolism Z86.718 Personal history of other venous thrombosis and embolism
🔧 COMMON CPT CODES (Embolism-Related Procedures)
Diagnostic Imaging
CPT Code Description 71275 CT angiography, thorax (CTPA — primary PE imaging) 78582 V/Q scan (pulmonary perfusion imaging with ventilation) 78580 Pulmonary perfusion imaging only 93306 Echocardiography with Doppler (assess RV strain in PE) 76706 Ultrasound, abdominal aorta, screening 93971 Duplex scan, extremity veins, unilateral (DVT workup) 93970 Duplex scan, extremity veins, bilateral Interventional / Surgical
CPT Code Description 37187 Percutaneous transluminal mechanical thrombectomy, venous 37188 Percutaneous transluminal mechanical thrombectomy, venous (repeat) 37212 Thrombolytic therapy, venous (infusion) 37213 Thrombolytic therapy, venous (continued infusion) 37184 Percutaneous transluminal mechanical thrombectomy, arterial 37185 Arterial thrombectomy (second vessel) 33973 Balloon pump insertion (for massive PE with cardiogenic shock) 37191 Insertion of IVC filter, endovascular 37192 Repositioning of IVC filter 37193 Retrieval of IVC filter 33999 Surgical pulmonary embolectomy (unlisted cardiac procedure — used with operative report) 34201 Embolectomy/thrombectomy, femoral/popliteal artery 34101 Embolectomy/thrombectomy, axillary, brachial, innominate, subclavian artery 34151 Embolectomy/thrombectomy, renal, celiac, mesenteric, aortoiliac artery
⚠️ Coding Note: Pulmonary embolism codes under I26.xx are MCC (Major Complication/Comorbidity) when associated with acute cor pulmonale and CC without it — making specificity critical for MS-DRG weight. Always document and code whether cor pulmonale is present. The saddle embolus codes (I26.02, I26.92, I74.01) are distinct and should be used when specifically documented — they reflect higher severity. For DVT + PE occurring together, code both the I26.xx and the appropriate I82.xx — they are not mutually exclusive. Chronic PE (I27.82) is separate from acute PE and represents organized, unresolved thrombus causing chronic pulmonary hypertension (CTEPH). For fat embolism post-fracture or orthopedic surgery, T79.1XXA carries the 7th character and must be sequenced appropriately with the causative condition.
DERIVATIONS of embolism
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Query functionality
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Med roots Appendix A Prefixes Appendix B Combining Forms Appendix C Suffixes Appendix D Suffix forms